Rationale and Objectives
Mobile mammography units provide preventive health care to patients facing barriers
to annual screening. This study reviews the outcomes of a mobile mammography service
during a recent 5-year period.
Materials and Methods
This retrospective study analyzed the examinations by mobile mammography during a
5-year period (9327 examinations). The patients recalled, biopsies performed, and
cancers detected were tallied. The race, age, breast cancer size, lymph node involvement,
and metastases were recorded. The positive predictive value (PPV) and cancer detection
rate metrics were calculated as outlined by the American College of Radiology Breast
Imaging Reporting and Data System Atlas.
Results
The program identified cancer in 14 cases (cancer detection rate = 1.5 per 1000 examinations
[95% confidence interval [CI], 0.9–2.5]) with 11 being invasive. The majority of these
cancers were small and of low stage. Lymph node status was determined in 11 of the
14 cases (1 as N1mi, 5 as N0, 4 as N1,1 as N2a). Abnormalities led to 1686 examinations
recalled (Recall Rate = 17.8%; PPV 1 = 0.8% [95% CI, 0.5%–1.4%]). One hundred and
one were recommended for biopsy (PPV 2 = 13.9% [95% CI, 8.4%–21.9%]), and 98 pursued
biopsy (PPV 3 = 14.3% [95% CI, 8.7%–22.6%]). Patient age ranged from 41 to 67 years
with an average of 50.6 years.
Conclusion
The program detected many cancers in an asymptomatic population facing barriers to
breast cancer screening. These findings are underscored by the cancers detected at
an early stage with a favorable prognosis and support the need for the development
of similar programs.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.Int J Cancer. 2015; 136: E359-E386
- Breast cancer statistics, 2015: convergence of incidence rates between black and white women.CA Cancer J Clin. 2016; 66: 31-42
- Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening.Lancet. 2003; 361: 1405-1410
- Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades.Radiology. 2011; 260: 658-663
- Mammography screening: a new estimate of number needed to screen to prevent one breast cancer death.AJR Am J Roentgenol. 2012; 198: 723-728
- Effect of screening and adjuvant therapy on mortality from breast cancer.N Engl J Med. 2005; 353: 1784-1792
- Identifying specific non-attending groups in breast cancer screening–population-based registry study of participation and socio-demography.BMC Cancer. 2012; 12: 518
- Cancer screening test use–United States, 2015.Morbid Mortal Weekly Rep. 2017; 66: 201
- Disparities in breast cancer prognostic factors by race, insurance status, and education.Cancer Causes Control. 2010; 21: 1445-1450
- Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of Sao Paulo State, Brazil.J Epidemiol Glob Health. 2015; 5: 211-219
- Socioeconomic deprivation, travel distance, location of service, and uptake of breast cancer screening in North Derbyshire, UK.J Epidemiol Commun Health. 2006; 60: 208-212
- Race, socioeconomic status and stage at diagnosis for five common malignancies.Cancer Causes Control. 2003; 14: 761-766
- A randomized clinical trial to assess the benefit of offering on-site mobile mammography in addition to health education for older women.AJR Am J Roentgenol. 2002; 179: 1509-1514
- Mobile mammography, race, and insurance: use trends over a decade at a comprehensive urban cancer center.J Oncol Pract. 2015; 11: e75-e80
- A mobile mammography pilot project to increase screening among Latina women of low socioeconomic status.Public Health Rep. 2010; 125: 765-771
- Mobile mammography: a model program for medically underserved women.Women's Health Issues. 1992; 2: 196-203
- Could mobile mammography reduce social and geographic inequalities in breast cancer screening participation.Prev Med. 2017; 100: 84-88
- How to establish a cost-effective mobile mammography program.AJR Am J Roentgenol. 2013; 201: W691-W697
- Mobile clinics for women's and children's health.Cochrane Database Syst Rev. 2016; (Issue 8:CD009677)
- ACR BI-RADS follow-up and outcome monitoring.ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. American College of Radiology, Reston, VA2013
- Breast cancer subtypes and the risk of local and regional relapse.J Clin Oncol. 2010; 28: 1684-1691
- Screening mammography for women in their 40s: a retrospective study of the potential impact of the U.S. Preventive Service Task Force's 2009 breast cancer screening recommendations.AJR Am J Roentgenol. 2013; 201: 1401-1406
Surveillance, Epidemiology, and End Results (SEER) Program(www.seer.cancer.gov) Research Data (1975-2016), National Cancer Institute, DCCPS, Surveillance Research Program, released April 2019, based on the November 2018 submission. Accessed April 23, 2019.
- Evidence to support screening women in their 40s.Radiol Clin North Am. 2017; 55: 429-439
- Cost-effectiveness of breast cancer screening in the National Breast and Cervical Cancer Early Detection Program.Cancer Causes Control. 2019; 30: 819-826
- Population-based mammography screening results in substantial savings in treatment costs for fatal breast cancer.Breast Cancer Res Treat. 2006; 98: 143-150
- Economic analysis of the breast cancer screening program used by the UK NHS: Should the program be maintained.Breast Cancer (Dove Med Press). 2017; 9: 217-225
- National performance benchmarks for modern screening digital mammography: update from the breast cancer surveillance consortium.Radiology. 2017; 283: 49-58
- Effectiveness of a mobile mammography program.AJR Am J Roentgenol. 2017; 209: 1426-1429
- Screening mammography for women in their 40s: the potential impact of the American Cancer Society and U.S. Preventive Services Task Force breast cancer screening recommendations.AJR Am J Roentgenol. 2017; 209: 697-702
- Availability of prior mammograms affects incomplete report rates in mobile screening mammography.Breast Cancer Res Treat. 2018; 171: 667-673
- Comparison of performance metrics with digital 2D versus tomosynthesis mammography in the diagnostic setting.Eur Radiol. 2019; 29: 477-484
- Performance of breast cancer screening using digital breast tomosynthesis: results from the prospective population-based Oslo Tomosynthesis Screening Trial.Breast Cancer Res Treat. 2018; 169: 489-496
Article info
Publication history
Published online: August 04, 2020
Footnotes
Financial Disclosures: The spouse of an author is an employee of STERIS Corporation. The authors declare that they have no other potential competing financial interest to disclose.
Identification
Copyright
Published by Elsevier Inc. on behalf of The Association of University Radiologists.
